Showing posts with label LP. Show all posts
Showing posts with label LP. Show all posts

Monday, June 5, 2017

Saturday, February 6, 2016

this is the face ...


... of a very unhappy boy!

Jax started coughing a really harsh dry cough on Monday morning. We already had an appointment at our clinic in Victoria for later that afternoon so I wasn't too concerned. He just had a dry cough and no other questionable symptoms. He handled his ventolin and inhaled antibiotic really well and we made our way to Jeneece Place for the night. He had a good night and we went to his chemo appointment as planned on Tuesday morning. It was a long day with an LP and IV chemo. Nurses and Doc listened carefully to his chest and it was all clear, so they advised me to just watch him carefully as the week went on, especially after his Dex wore off early next week. (Dex elevates his white blood count, so once the elevation wears off, viral illnesses can become more intense.) The cough lingered and then on Thursday he started having a stuffy nose. Since he's always more sensitive and moody while on Dex, adding in the illness has made him a very grumpy bear.

Friday night he hardly slept at all. Coughing non-stop. Ever since he was just little, he tends to cough so hard that he vomits. That's been in full force this week too. Yuck. He was so miserable last night, and we couldn't give him anything to help him feel better, since Tylenol is a no-go for someone with a VAD. We can't give it because it can mask a fever which could lead to missing out on catching a bacterial infection. A bacterial infection can be very dangerous for someone who is immune-suppressed. 

Because his VAD line goes directly into his heart, 
we have to take fevers very seriously. Every time. 

He begged for the morning to come so he could get out of bed and lay on the couch. He finally napped late this morning but when he woke up I could tell his temperature was significantly elevated. I had checked a few times through the morning and he was always within normal range and this time when I checked it was 39.4. I've never seen his temp go that high so I jumped into flight mode. I grabbed a few things, put Emla (numbing cream) on his port and got him packed up to go. Paul had taken the car into Lake Cowichan so I called him to get home right away. He swooped in and helped me get everything ready to go and called the hospital to let ER know we were on our way. 

Once we got there he was seen by triage right away and his temp was a bit lower but hovering very close to the threshold to begin what's called Clinical Order Set - Fever and Neutropenia Protocol. Long name with a bunch of steps to take for a chemo patient with a fever. We were soon given a private room and nurse and doc saw him right away. His temp was still so very close to the magic number that they decided to begin antibiotics. He got some tylenol and codeine (supposedly has cough suppressant properties), chest x-ray (looks good), and first dose of prophylactic antibiotics to cover any bacterial infection that may be brewing. He was seen by the pediatrician on call, who agreed with the ER doc that it's a standard cold virus but protocol would continue until blood cultures have been 48 hours to show any signs of infection.

The nurses decided not to use his VAD port for drawing the bloodwork. I was happy they didn't want to access his port unless necessary, but not happy about having to tell Jax that he'd be getting an arm poke without any numbing cream. He agreed to it on the promise I gave that the lady knows what she's doing and it wouldn't be as bad as he anticipated.

It was bad. 

She missed his vein the first time and spent a minute re-aligning to try to make it work, but to no avail.  The plan after that was to give Jax a break, put Emla on the other arm, and have a different tech come attempt the IV. 15 minutes later that happened and she got it on the first try.

Not long after that we had to get going with accessing his VAD. Sadly, the Emla I had put on it at home 3 hours prior had lost its potency so he felt the pinch on that one also. 3 pokes with very little numbing is hard for a boy who usually doesn't have to feel much from pokes. 

As grumpy as he was, he was rocking some totally rad bed head.


Once the meds kicked in he started to feel much better.


We're thankful this didn't happen in the middle of the night, thankful that this is a rare occurence for us (only his third fever since diagnosis in April 2014), and thankful it seems to be viral and he'll come through just fine. Many oncology patients and their families spend countless days and nights in the ER and admitted to hospital, dealing with serious infections and complications from the powerful medications used to attempt to restore these kids to health. I just found out that our little buddy Marek was in ICU for 9 days this past month. That could just as easily have been our situation.

As I write this he's been asleep for about 2 hours with just a few coughs. In a strange twist ... now that I'm actually allowed to give him Tylenol to make him more comfortable (because he's already getting antibiotics and blood cultures have been drawn) ... he's refusing to take it. He did accept a Gravol though, so there's that. I can tell he's having a good sleep because he's doing the cute little sigh-coo thing that he does when he's sedated for his LPs.

After his LP on Tuesday, in his loopy state, he said "That was fun! That was the best back poke ever! Mom - you have FOUR eyes, TWO noses TWO moufs ... and ONE CHIN." (Yay, just one chin!)


Sunday, October 18, 2015

when cancer came (part three)


We were told the night before that our helicopter would be arriving first thing in the morning, and it arrived before 8:00. Jax had still been dozing on and off so I woke him up with the news of the helicopter ride happening very soon. I had just enough time to grab some more snacks from the parent kitchen. Jax wasn't allowed to eat because of the tests and procedures waiting for him at BCCH. He was calm and trusting as we waited for the paramedic team to get organized. Our morning nurse, Andrea, was amazing.

The paramedics were efficient and professional, and they got him snugly wrapped up for the ride across the water.  He wasn't scared, and I think he was even a little bit excited. I awoke with renewed hope that whatever was causing his blood work to go so wonky would be a temporary problem with an easy solution. There was a mood of anticipation rather than dread. Taking a content 5-year old for a helicopter ride has a way of doing that, I suppose.
Walking across the parking lot to the waiting helicopter.
They offered to take a pic of the two of us before loading.


He went in first and once his stretcher was locked in place,
I went around the other side to find my seat.

It was a beautiful day for a flight, and a great day to save a life!


Our family doctor later told me that just as she was arriving at the hospital to do her morning rounds, she saw the helicopter take off, and knew that it was taking us to Vancouver.

From our friend Joanne in Crofton ... 
"We were outside when you flew over. 
I was praying on the driveway and Geoff was 
waving and praying from the back yard."
(It was Geoff's birthday that day.)
It was really loud! Jax had a headset to dull the sound, no mic. 
He could hear the chatter between me and the paramedics.
This pic was featured on the front page of our
small town newspaper a few days later,
with details about Jaxon's diagnosis.


We landed at the Vancouver Airport and then went by ambulance to BCCH. We later learned that the helicopter flies directly to the hospital for more critical traumas and illnesses. Jax was very critically ill but stable enough to take a bit longer to get to the hospital.

Read here to learn more about the 
servicing BC & Yukon.

I followed the paramedics and their precious cargo down a long hallway. My heart caught in my throat as I saw the sign indicating we were entering the Oncology Clinic. Another long hallway past a bunch of small offices and treatment rooms, then into the heart of the clinic. This was the sign on the outside of the room where Paul was waiting for us. I don't know if he was in the isolation room because of his mild cold symptoms, or if that was the only one available.
Hugs all around and worried looks exchanged between the parents. Tears in Daddy's eyes. He had a long time to sit in that little room and wait for us. Jax settled onto the stretcher bed, still happy and compliant with all we were asking of him. I think someone must have put some freezy cream on his hand in preparation to do another blood draw and to start an IV. It was clear that he required a blood transfusion, but the team needed to know what caused such chaos in his blood. They probably knew much more than they let on at that time, but didn't tell us much until they had confirmation. We answered all kinds of questions about his symptoms, his medical history, family medical history ... many times over for many different people.
We changed him out of his shirt and into a hospital gown as it was easier and comfier for all the exams he endured from various doctors and nurses. A medical student started the line for his IV. He did not cry. None of us were thrilled by the student's shaky hands and the mess she made with his blood on the bedsheet. She admitted that she still gets nervous when starting IVs. But the good news was that she picked a really good vein that served his IV needs well for that day and the next.

As displeased as he was about the IV in his hand, he liked the sticker they put on the cut-in-half medicine cup that was protecting the needle ... a golden retriever puppy, much like our Tucker!
We were moved to a different room in the clinic after that. It was in that room that two doctors, both young and beautiful and both named Ashley, as well as a few other people - nurses? Social worker? I don't know - came in to tell us that they had confirmed the presence of leukemia cells (blasts) in his peripheral blood. With tears in her eyes, Ashley S. told us that they couldn't say definitively that he had leukemia until they looked at his bone marrow under the microscope, but that since they saw blasts in his peripheral bloodstream, it was guaranteed to be in the marrow. 

We learned later that meeting with oncology doctors and parents and bad news is referred to as "disclosure".

We were told that he would be going very shortly for the sedated bone marrow biopsy to confirm his diagnosis and would receive his first dose of chemotherapy into his spine.

It must have been at this point that I didn't know whether to cry, shout, vomit, or lay on the cold dirty floor of the tiny little room we occupied. I was hungry, thirsty, tired, terrified.

I've since heard other parents describe those moments as ...

"and a black fear swooped in"

"And the water rushed all around me
and sucked all the air out of the room."

My friend-in-real-life (and fellow Momcologist) Christie said: said:
"I'm writing to make some sense of all of this. It's moving so fast. And my brain is moving so slow. That feeling when you walk into a room to get something, but can't remember what. The fog. I feel like that - all the time. They kept asking us 'do you understand why you're here?' Over and over. Were they expecting more tears? Are we doing this wrong? What a stupid thing to think at a time like this."

I won't say that it's the worst news a parent can hear, because it's not. There are worse things. This was our hardest thing. For Paul and I - it was our darkest hour.

We probably made some phone calls and sent texts to family and friends then. Jax was content watching movies, though he was very hungry! He hadn't eaten anything for about 20 hours.

They came to take him, and us, to the procedure room. Some call it the bubble room. They have a bubble machine to use as a distraction for distraught kiddos. We didn't need the bubbles this time.



I'll never forget the moment I rounded the corner into the room with Jax in my arms. As soon as we entered with our nurse, what seemed like a dozen people in the room turned to look at us. Most wearing scrubs and stethoscopes, some in gloves already, others with paperwork. Their chatter stopped. They were standing, sitting, waiting to take us and our boy somewhere no child or family should ever have to go.

Paul vacated the room pretty quickly. He knew that he'd be out cold himself if he stayed any longer.

I laid Jax on the stretcher and snuggled him until the sleepy medicine took effect. I remember looking at all those faces as I backed out of the room.

Paul was waiting for me in the hallway, just outside the opaque glass doors that someone closed after I left the room. We embraced, and that's when the sobs came. We stood there a minute or two, absorbing what had just happened. Paul said through his tears, "those were angels in there".

We went back to our little cubicle room with glass doors and drew the curtains. I laid on the bed where Jaxon had watched 3 or 4 movies earlier that day. I sobbed, Paul wept quietly. Suddenly all the "what if" and "if only" thoughts came to my mind. Paul talked me through all that, and we chose to focus on that day forward, and not to dwell on why or how we got to be there.

More phone calls. More texts.

I'm not sure how long he was away from us. I know now that 
a lumbar puncture procedure is typically done in under 10 minutes. A bone marrow biopsy likely doesn't take much longer.

He returned to us on the stretcher from the procedure room, still sleeping. A nurse or two came in to monitor his vital signs as he was coming out of the sedation. A few different nurses were there, trading off, and also chatting with us.

Sometime around 5pm, Dr. Ashley came to tell us that the bone marrow biopsy confirmed the diagnosis ... Leukemia. 

Drowning again. 

There were so many faces we met that first day. Doctors, interns, residents, fellows, students, nurses, social worker, research coordinator ... so many. They told us that although it was known to be leukemia, further pathology testing would tell us what main-type and sub-type it was. Knowing those things would dictate the next steps to be taken. There would be a "Family Meeting" the following afternoon for more details, questions and answers.

Then it was time to head upstairs to the oncology ward. 

Our child. Cancer patient.
Paul, Jax & Clinic Nurse Danielle, as we ventured down more unbearably long hallways, then upstairs to Ward 3B, Room 14.


Because of a Norwalk type of virus that was spreading between the two wards (on two different floors) of the oncology department, space was limited. We had roommates. More about them another time.

Our dear friends Frank and Sherri came to bring us McDonald's dinner (at Jaxon's request and against their better judgement). They brought food, hugs, prayers, laughter and encouragement.


Once Jax and I were fed and settled, Paul left to go somewhere to sleep. I think it was to the Easter Seal House.


That was Day One.

Monday, December 29, 2014

RMH & BCCH in December

Most of Jaxon's treatment is done at an outpatient clinic in Victoria, a satellite campus of the BCCH Oncology Program. We are required to pay a visit to The Mother Ship (BCCH) once every six months, and also have to be there for any super duper special parts of his treatment protocol. More about that in another post. And so we went in December. Max and Marty had not yet stayed at the new Ronald McDonald House in Vancouver, so they were very eager to go. I didn't mind taking them, as it was a quick trip with a low-key day in the clinic. It certainly was a lot more work to have the older boys there with me, but I'm glad they got to experience it with me and Jax. It also made things much easier for Paul here at home for me to take the boys as it was during the work week. But next time? I'll try to go with just the wee one.

Heading back to the car after finding some snacks inside the ferry terminal.
Enjoying the view from our complimentary State Room on BC Ferries.
Available to Jaxon anytime he travels, thanks to our super great social workers in Vancouver and Victoria.  I think only the Victoria ferries have state rooms, so that's the route we take. So nice to have space to spread out our stuff (Lego building!) and lay down if needed. Sometimes they even give me the key so we can leave the room to get food or go for a walk. But otherwise we have all we need, even a bathroom! I must remember to take bleach wipes onboard with me next time because it's certainly not any cleaner than the rest of the boat. 
Happy boy to FINALLY be at the new RMH!
Pic taken before I knew that sitting on the slide is a no-
no.
RMH Grand Living Room beautifully decorated with fourteen Christmas trees!
One of our favourite clinic nurses sensed that Jax would need a distraction upon entering the procedure room*, so the bubble machine welcomed him for the first time. Good fun while the good sleepy doc snuck some good sleepy milk into Jax's line. I get to stay in the room for his LPs in Victoria, and have several good pictures from previous ones. I plan to post them, with a warning ahead of time for those lightweights who aren't so fond of medical procedure documentation.
*The 30 minutes that Jax spent delaying and trying to avoid getting his port accessed, followed by the hysterics when me and 2 nurses had to just go for it
was a good indication that he was displeased with the goings-on.
He had a visit from physio lady Anne who put him through a whole bunch of tests to check his nerve function in hands, feet, and knees, balance and range of motion on his feet. Vincristine is the medicine that he'll be getting the most of
(has had plenty since the beginning of treatment and will continue monthly through LTM) and it is known to cause neuropathy, to varying degrees.
We soon discovered it was a great day to be at BCCH as the Canucks were there
to visit! Marty and Jax posed with Fin before they chased him down the hall trying to pick a fight with him as he followed the rest of the team upstairs.
 
Max's first selfie! Thanks Fin!
My boys were sort of impressed, and were excited enough to pose for a pic with these guys (Daniel Sedin, Weber, Horvat, Higgins). They each got signed postcards from 12 players! We saw our favourite, Dan Hamhuis, and Jax was friendlier to him this time than when we met him and his wife Sarah at BCCH in May.
Our friend Marek!
We met Marek and his parents in the early days following Jaxon's diagnosis. He has the same diagnosis as Jax, received one day apart. They live in Whitehorse where there is no oncology facility nearby. He and his Mom have been living in Vancouver since April, and are eager to head home in the coming weeks. They will fly to Vancouver for the remainder of his monthly treatments. We're so glad that they were still there when we made the trip over to begin LTM. This time he and Jax were in the clinic at the same time, recovering from their LPs in rooms side by side. He is 3, with the same light brown hair and dark brown eyes as Jax. They look like brothers! Super special friends. He cried when it was time to say goodbye. Feeling thankful that he'll soon be home to rough-house with his own big brothers and sister.
This pic taken after I knew it was a no-no to sit on the slide, but just so cute!
Hard to get a good pic of that boy - always on the move!
Me and Marek's mama, Amanda. I'm so very grateful to have a friend alongside me in this marathon who is going through so much of the same things. Every cancer story is different from all the others, but there are so many commonalities as well. Love you, Lady. Thanks for the socks.
We received free admission via RMH to see the Festival of Lights at
VanDusen Gardens.  
So many lights! It was hard to take pics of the boys
with the poor lighting and they ran the whole time.  (Looks like I should have looked at the website before we went so we could have seen some of the extra indoor activities. SCANDINAVIAN GNOMES! Lego Room of Joy! Shadow puppet show!) It was lovely, and great fun to make some memories with Marek and his Mum (and Grandma!) outside of the hospital and RMH.

Sunday, December 28, 2014

The Long Haul (LTM)

On December 11, Jaxon began Day 1 of Long-Term Maintenance (LTM) at BCCH in Vancouver. I haven't written much about this phase leading up to it for a few reasons. One reason is that the treatment plan up until then was really super complicated, and the other is that there were further confusing details surrounding the Long-Term portion of his treatment.
(Plus, it just seemed so far away!)

"Frontline" treatment for Average Risk Acute Lymphoblastic Leukemia ...
Induction (4 weeks) 
Consolidation (4 weeks)
Interim Maintenance 1 (IM1 - 8 weeks)
Delayed Intensification (DI - 8 weeks)
Interim Maintenance 2 (IM2 - 8 weeks)

Hard to believe that we made it through all that with very little delays, setbacks or complications. We are so grateful for that, knowing that things could have gone very differently.

December 11, 2014 - Day 1 of an 85-day cycle to be repeated approximately 10 times, until spring/summer 2017, about 30 months. (30 months because he's a boy. Girls get one year less LTM because they don't have test!cles. Having test!cles makes boys susceptible to a relapse of the Leukemia so they get chemo for a longer time to make sure every last abnormal cell is eradicated.) 

He's had 37 weeks of treatment since diagnosis on April 10. Granted, those 37 weeks were considerably more intensive than these next 30 months are anticipated to be. We hope and pray that as much of that as possible will be uneventful cancer-butt-kicking. There are absolutely no guarantees that it's now smooth sailing. We must remain vigilant to protect him from "every day" illnesses, no matter how seemingly insignificant as they can lead to a multitude of the aforementioned (and thankfully avoided thus far) delays, setbacks, and complications. Until the end of his treatment, if he spikes a fever, he needs IV antibiotics within 30 minutes, as he could very rapidly crash into septic shock. That's why we are cautiously selective when it comes to social interactions and why we ask you to consider the ways you can help reduce the spread of illness. (Flu shot, anyone?)

Here's the rundown for LTM ...

• Daily oral chemo at home (for NINE HUNDRED DAYS, give or take a few)
(Mercaptopurine aka 6MP: 50mg M-Th and 75mg Fri-Sun)

• 3 days weekly antibiotics to help prevent PCP Pneumonia
(Septra: 40mg twice daily for 3 days every week)

• Weekly oral chemo at home (Methotrexate: 3 x 10mg tabs every Thursday)

• Monthly IV chemo at hospital (Vincristine: 1.2mg) Next one Jan. 7

• 5 days every month of oral steroids
(Dexamethasone: 2.5mg twice daily for 5 days)

• Lumbar Puncture (LP or spinal tap) one every 3 months (to check spinal fluid for cancer cells and to  inject chemo into spinal fluid, because IV/Oral chemo does not cross the blood/brain barrier). He had an LP on Day 1 of this cycle and the next one is scheduled for March 4 - Day 1 of the next cycle.

And to spice things up - the daily 6MP and Methotrexate need to be taken on an empty stomach, and the 5 days of steroids every month make him ravenously hungry for about 10 days every month. Good times!

Bloodwork on Dec. 22 confirmed that the at-home meds are properly balanced. Off to a good start.

Since the end of May, the majority of his treatment has been done at the Pediatric Oncology/Hematology Outpatient Clinic at Victoria General Hospital. There, we have a fabulous Pediatric Oncologist and exceptional nursing team. We are required to see our Oncologist at BCCH in Vancouver once every six months. We are fond of the team at BCCH too, but it's so nice to get most treatment closer to home.

Soon, I plan to write about his participation in a clinical trial that is ever-so-slightly tweaking the recipe for the chemo cocktail for kids with ALL, with a goal to see if less of some meds and more of another med will result in better long-term survival rates with less incidence of long-term side effects.

Wednesday, November 19, 2014

that was a very long day

November 12th
Interim Maintenance 2 - Day 31 {of 56}

We often have loooooong days in the clinic at our sort-of-local hospital in Victoria, or at BC Children's. Most clinic days are long-ish. I rarely make any other plans on clinic days. Anything extra that gets accomplished is a bonus. We usually know when a day will be exceptionally long, but sometimes we don't. Last Wednesday (IM2 Day 31) was one of the days we were there much longer than expected. Jax had a scheduled LP (#11 - only about 11 more to go between now and June 2017!) and additional IV chemo. The LP always gets done first. Jax, Marty and I slept at Jeneece Place the night before so we'd have an easy morning before the appointment. We got to the hospital at about 8:40 and began the process of weighing, measuring, vitals-taking, port accessing, waiting around for bloodwork results. This visit also required fasting since he'd be sedated for the LP. By about 10/10:30 we learned there was a delay as the pediatric intensivist we needed for Jaxon's sedation was in the ICU with a child in an acute trauma situation (ill or injured, I'm not sure). At 11:00 we learned that the earliest possible time for Jax's LP to go ahead was 1pm. Ugh. That is a long time to be waiting around, not eating. Marty and I didn't eat or drink in front of Jax since we was not allowed. I managed to sneak out and get Marty some cereal, and then later a bagel that he ate in another room. I got my tea before my didn't-have-my-tea-yet headache could kick in. I even managed to get to the cafeteria for the famed Butter Chicken that is only served on Wednesdays. It was really, really tasty. I ate it outside Jax's room. By 12:30 he was getting super duper antsy, hungry, thirsty, and thusly - cranky. The intensivist did indeed show up at 1:00 so we were able to get the LP going. I'm amazed at what our oncologist can do in a span of just a few minutes after Jax falls asleep. She accesses his cerebrospinal fluid, harvests a small vial of it for analysis (has always been cancer-free), and injects 8mg of chemo directly into his spinal column. This is done because IV chemo does not cross the blood/brain barrier so any sneaky cancer cells hiding in there would have free reign.

The LP procedure finished in record time and he woke up quickly. He had to stay horizontal for an hour to prevent a headache and to allow the medicine to spread out in his spinal fluid. Once he was no longer seeing double, thanks to the sleepy meds he had, TV watching ensued. We had the "private suite" for the day, because of the LP and the entourage of medical folks that come along with it. Marty made himself quite at home in the treatment room beside us with a DS, blankie and pillow on the couch.

As unpleasant as the hungry waiting-for-a-spinal-tap was, I was comforted knowing that my child was not in an urgent care situation, and the thought of the other family going through a time of umcertainty put our delay into perspective.

Heather, Child Life student, came with Christmas crafts for the boys.
Each decorated a clear ball ornament and Jax did an extra one that
will be on a special tree on display at the Empress Hotel!
IV chemo of the Vincristine and Methotrexate variety were administered in short order, and we were soon on our way. We left by about 3pm and headed to Jeneece Place to pack up and head home. Jax fell asleep in the stroller on the 5 minute walk from the hospital to JP, and slept about another hour while I packed and loaded the car. He woke up just in time to realize he didn't get to play on the outdoor riding toys at JP but was consoled by the promise of pizza on the way home. Both boys then napped in the car. It was a late bedtime that night as they were full of energy from all that snoozing.

Jaxon's next treatment (IM2 Day 41) is Monday, November 24th, which also happens to be my birthday. He and I will spend the day at the clinic then we'll head back home for our Imadene Staff Family Christmas Dinner Extravaganza.

Following that appointment, the next big day is bloodwork on December 9 to see if he's good to go to start LONG-TERM MAINTENANCE in Vancouver on December 10. If he passes his blood test, he and I will go straight to the ferry. I'm hoping we are able to stay at RMH for that night and the next one.

The protocol for rest of Jaxon's tratment, Long-Term Maintenance is yet to be determined. He is part of a large study about the best way to treat ALL with successful outcomes and minimal long-lasting side effects. He will be on one of 4 arms of treatment and it's really confusing to try to explain, but I'll do my best ... but that's another post.

Sometimes I forget that he's fighting the greatest battle of his wee little life ...


Monday, October 20, 2014

onward!

As we hoped, Jaxon passed his blood test on Tuesday last week, and we were able to start the next round of his treatment protocol. He needed a minimum of .75 ANC and he gave us .93! Platelets needed to be 75 and they're hovering nicely around 400.

Interim Maintenance 2 (IM2)
• IT (Intrathecal = into spinal fluid via sedated lumbar puncture) Methotrexate - Days 1 & 31.
These will be LP #s 10 and 11. Each time he gets IT chemo, a sample of his spinal fluid is collected and checked for leukemic cells. These have always come back clear.

• IV Vincristine & Methotrexate - Days 1, 11, 21, 31, 41

• Septra (oral tablet via jelly bean) 2x daily every Fri/Sat/Sun

IM2 is the final phase in his "frontline" treatment, before Long Term Maintenance begins in Mid-December. With the conclusion of Delayed Intensification, we hope and pray the most gruelling phases are now behind us. We must still be ever vigilant to watch for any signs that his body is not handling the chemo well, or for illness. Paul had a cold for well over a week, and it passed on to Max and Oma. Marty and Jax had a slight cold, but nothing too terrible. It hit me the past few days and I feel a bit run down but not suffering badly. I was worried about passing it on to Jaxon until I realized that he probably gave it to me! I'll call the clinic tomorrow and see if they want me to take any extra precautions, though I feel it's a non-issue as he would have already been exposed to my germs before I had any symptoms.

Nurse Clinician Anne, Dr. Ewa, Nurse Barb
"Checking chemo".  The chemo gets hand delivered from the pharmacy to the Oncology treatment room in that red tackle box. Then one nurse checks it with another nurse to confirm the patient's name, ID #, what the medicine is, how much medicine it is, when the medicine expires, and how
it is to be administered. If in agreement, the nurse presents the medicine to the Dr. prior to administering. The nurse also verifies all the same information with the parent/caregiver.

Super Jax strikes again!
Many thanks to Jaxon's friend Tatum and my friend Becky for this super cool, one of a kind toque! 

Speaking of super cool and one of a kind ...
Thanks so much to my Mama for making these!

And if matching fish hats isn't enough ...
We love our new cozy blankies! I have one too, each of us with a different colour. 

Funny boy ... he came out of his room about half an hour ago and we quickly realized he was still asleep! He didn't really answer our questions and seemed really dazed. He came to snuggle with me but started wimpering and giving obvious "have to pee" cues. I asked him if he had to and he nodded. I told him to go! He hopped down and went straight into the other bedroom. I redirected him and scooped him up onto the loo. On the way there and while he did the deed, he was giggling uncontrollably. I guess he thought it was pretty funny that he went to the bedroom, looking for the toilet. He declined any drinks of water and went straight back to bed.